Harvard Women's Health Watch

Novel foot-health program reduces falls in older people

About a third of people over age 65 fall each year, and foot problems are one of the major causes. A foot-health program combining orthoses (shoe inserts), footwear advice, and foot and ankle exercises can help prevent such falls, according to an Australian study published online June 16, 2011, in BMJ. Many guidelines for fall prevention suggest that older people who've experienced falls or have difficulty walking should have their feet and footwear examined by a podiatrist (foot specialist), but they don't indicate what, specifically, should be assessed or what people can do to prevent falls. The Australian study helps fill the gap.

The study. The participants in this yearlong randomized trial were 305 women and men ages 65 to 93 with disabling foot pain. Half of the participants received only routine podiatric care, and the other half were enrolled in the foot-health program as well. Patients assigned to the program received premade foot orthoses (molded to conform to the patient's foot), an educational booklet on fall prevention, and advice on choosing proper footwear. They also performed a 30-minute foot and ankle exercise regimen at home, three times a week, for six months. All participants recorded their falls and underwent clinical foot assessments at the start of the study and again six months later.

Results. The percentage of participants in each group who fell during the yearlong study was about the same, but the number of falls was not. The intervention group reported 36% fewer falls than the routine-care group — a significant difference. Of the eight fall-related fractures, seven occurred in the control group. At the six-month clinical assessment, participants in the foot-health program showed improvements in ankle strength, range of motion, and balance, compared with people in the routine-care group.

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